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FILE - In this Jan. 18, 2012, file photo, Nevada Gov. Brian Sandoval speaks in his office in Carson City, Nev. Don't mistake Sandoval's invitations to the Republican presidential contenders as anything more than a hospitable gesture. The governor is staying out of the nomination fight despite his rising stature in the GOP, or perhaps because of it. Sandoval has invited the candidates to his office this week as they campaign ahead of Saturday’s caucuses. If they make the trip to Carson City, they can count on a smile and a firm handshake but no public stamp of approval. (AP Photo/Cathleen Allison, File)

Nevada governor first Republican to support Medicaid expansion under Obamacare

CARSON CITY, Nev. (AP) — Gov. Brian Sandoval said Tuesday he’ll support expanding Medicaid eligibility in Nevada as called for under the federal health care law to provide coverage for the state’s neediest residents.

In an exclusive interview with The Associated Press, Sandoval said expanding coverage will add 78,000 residents to the state’s Medicaid rolls, but save the state $16 million in mental health programs that otherwise would be paid for out of the state general fund.

The first-term Republican governor said while he opposed the health care law, his decision will help tens of thousands of people. About 22 percent, or 604,000 Nevadans, are uninsured.

He added that his budget to be released to lawmakers in January will propose reducing taxes paid by small businesses to help them afford insurance coverage for their employees. He will also ask the Legislature to support a “cost-sharing” copayment for recipients who receive Medicaid services.

“I don’t think it’s any secret I’ve never been an advocate for the Affordable Care Act,” Sandoval said.

But after weighing the options, he said it was in the state’s best interest to expand coverage for the poor.

“It would cost the state $16 million more not to opt in,” he said.

U.S. Sen. Harry Reid, who helped usher the health care law through Congress, commended Sandoval “for taking this bipartisan step.”

“This is a win-win,” the Senate majority leader said in a statement. “It will save the state money, is good for the economy, good for employers and most importantly will help people.”

The U.S Supreme Court in June upheld the federal law that was challenged by 26 states. Though the court upheld the mandate that people could be required to purchase health insurance or pay a tax, it also said state’s cannot lose existing Medicaid funding if they don’t increase their Medicaid coverage levels for adults.

That left states with the option to “opt out,” and 12 have said they’ll turn down the expansion, though the issue is being hotly debated in many state legislatures. Nevada joins about 14 states that have said they’ll accept it.

“It’s untenable that you’re going to tax 68,000 individuals,” Sandoval said, further explaining his decision. “It’s untenable to me all these businesses are going to be subject to tax” for not providing insurance.

“All in all, it makes the best sense for the state to opt in,” he said. “This is a way for me to protect these people.”

Sandoval decided to commit to covering people up to 138 percent of the federal poverty level beginning in 2014.